SUMMARY This application requests funds for support of the 2019 Second International Fetal Heart Symposium event scheduled for April 25-27. 2019. This Symposium encompasses topics related to fetal heart, new imaging modalities and new advances such as stem cell transplantation in congenital heart defects. Its focus is to improve understanding the genetic etiology behind heart defects, understanding the mechanisms of fetal heart formation, application of new imaging modalities to detect heart defects as early as possible and application of tissue engineering techniques to improve surgical outcomes, especially in single ventricular repair. Congenital heart defects (CHD) are the most common structural abnormalities in the fetus with an incidence of 6-8/1000. The etiology of CHD can be divided into genetic and environmental factors and most of the studies indicate that it could be multifactorial. In spite of that, 70% of CHD occur for unknown reasons. It is very well known that prenatal detection of CHD improves postnatal outcomes; therefore, diagnosis in utero is important to plan the pregnancy. Because perinatal medicine is a multidisciplinary field, the goal of the Symposium is to bring together basic scientists, radiologists, sonographers, geneticists, perinatologists, pediatric cardiologists, cardiac surgeons, medical students, and nurses to discuss the screening methods, early detection, new imaging modalities and improvements in outcomes. The proposed 2.5 day Symposium includes organized didactic sessions and facilitative learning. The six specific goals of this symposium are: 1) Demonstrate improved practice strategies regarding the important concepts of congenital heart disease. 2) Define the advancements in imaging technology. 3) Demonstrate greater competence in the diagnosis and management of fetal cardiac abnormalities. 4) Describe the latest advances in screening, diagnosing and treatment of congenital heart diseases. 5) Describe the most associated extra cardiac anomalies along with heart defects and learn how to manage pregnant women prenatally. 6) Demonstrate new advances in postnatal management and stem cell therapy in major cardiac defects. Speakers will include senior investigators, well established in their fields of fetal and pediatric cardiology, genetics and cardiac surgery. The Hands-on session will address practical tips of fetal echocardiography application, and understanding the different Doppler modalities in assessments of cardiac function.